An Integrative and Complementary Approach to Hepatitis C

Hepatitis C, a liver infection primarily caused by the hepatitis C virus, affects an estimated 2.7 – 3.9 million people in the United States, with approximately 17,000 new cases diagnosed each year. Its insidious nature often leads to serious liver complications, making it a significant health concern. The progression from infection to potential chronic stages and eventual complications like cirrhosis or liver cancer underscores the importance of timely diagnosis and effective management.

This article discusses the integrative approaches to supporting those with hepatitis C, including conventional treatments, nutrition guidelines, beneficial supplements, and the profound effects of mind-body therapies in managing and potentially alleviating the disease's impact on one's quality of life.

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What is Hepatitis C?

Hepatitis C is a viral infection that targets the liver and can lead to serious complications if left untreated. It's caused by the hepatitis C RNA virus, which enters liver cells and then begins its complex replication process. Once inside the cell, the virus translates its RNA into proteins. These proteins help the virus replicate and are eventually packed into new viral particles, which are released to infect other cells. Interestingly, hepatitis C doesn’t embed itself into our DNA; it operates outside of our genome.

There are several types or "genotypes" of the hepatitis C virus. The most common one, especially in the U.S., is genotype 1. It's significant to note that this genotype is linked with more severe liver disease and has a higher risk of leading to liver cancer. In fact, in the US, genotype 1 represents about 60% of all hepatitis C cases. Other genotypes like 2a, 3b, and 2c are less common but are generally more responsive to treatments (5). 

After exposure to the virus, it can be found in the blood within a few days to weeks. For many, the virus persists and can lead to chronic infection. This chronic stage isn't directly harmful due to the virus itself but rather the body's inflammatory response. Over time, this can result in liver damage. There are various factors, like alcohol use, other infections, certain genotypes, and lifestyle factors, such as obesity, which can speed up liver damage. Furthermore, advanced liver damage can increase the risk of liver cancer (5). 

What Are The Possible Causes of Hepatitis C?

Hepatitis C is a liver infection caused primarily by the hepatitis C virus (HCV). The primary mode of transmission is through direct contact with the blood of an infected person. This can happen through various means, such as sharing needles or syringes, getting tattoos or piercings with unsterilized equipment, or from a healthcare setting where improper equipment sterilization occurs. Blood transfusions and organ transplants were once a common mode of transmission, but in many countries, screening has reduced the risk. There is also a risk of transmission from an infected mother to her child during childbirth.

Various factors can increase the risk of hepatitis C infection. The effects of lifestyle choices, such as using intravenous drugs or having unprotected sex with someone who has a history of drug use or multiple sexual partners, can pose a risk (10). 

Functional Medicine Labs to Assess Liver Function

Functional medicine labs offer a variety of tests that can help tailor treatment to patients, allowing providers to optimize management strategies.

Hepatic Function Panel

The Hepatic Function Panel is a collection of tests that gives a broad overview of the liver's performance and overall health. This panel assesses various components, such as bilirubin, albumin, and proteins, to ensure the liver is effectively processing nutrients, producing bile, and filtering toxins from the bloodstream.

GGT (Gamma-Glutamyl Transferase)

Gamma-glutamyl transferase (GGT) is an enzyme primarily found in the liver. Elevated levels of GGT in the bloodstream are a sensitive indicator of liver damage or disease. 

AST (Aspartate Aminotransferase)

Aspartate aminotransferase is an enzyme found in various tissues but is primarily located in the liver and heart. Elevated AST levels, especially when paired with ALT levels, can be indicative of liver damage or inflammation (11). 

ALT (Alanine Aminotransferase)

Alanine aminotransferase (ALT) is an enzyme predominantly found in the liver. It plays a vital role in breaking down proteins and producing energy for liver cells. When the liver is damaged or inflamed, ALT is released into the bloodstream (11). 

Conventional Treatment for Hepatitis C

Hepatitis C is conventionally treated with antiviral medicines, aiming to clear the virus from the body. Newer direct-acting antiviral medicines have resulted in better patient outcomes fewer side effects, and sometimes require only eight weeks of treatment, though the typical duration is 12 weeks. The specific medication and treatment duration are influenced by factors like the hepatitis C genotype and the liver's condition. For those with severe liver damage from chronic hepatitis C infection, a liver transplant may be considered, though the virus often returns post-transplant, necessitating further antiviral treatments (10). 

Integrative Approach to Supporting Those with Hepatitis C

An integrative approach to managing hepatitis C combines conventional medical treatments with therapies centered on nutrition, supplements, and mind-body practices.

Integrative Nutrition for Hepatitis C

Integrative nutrition for hepatitis C patients emphasizes the importance of maintaining a balanced diet to counteract the disease's effects on health and quality of life. Malnutrition, especially evident in chronic liver diseases' advanced stages, can significantly impact health-related quality of life (HRQOL). Notably, in individuals with chronic HCV, a decline in skeletal muscle mass, indicative of early undernourishment, often occurs before the onset of cirrhosis. As there's a profound connection between HRQOL, nutrition, and physical activity, monitoring and addressing musculoskeletal abnormalities is essential for all stages of chronic hepatitis C. 

A balanced diet rich in fruits, vegetables, lean proteins, and whole grains not only supports liver health but also sustains healthy skeletal muscle, thereby countering the effects of sarcopenia (age-related progressive loss of muscle mass and strength) on HRQOL. Conversely, being overweight or obese, coupled with chronic HCV infection, can lead to insulin resistance, further impairing HRQOL. 

Therefore, the best dietary recommendation for hepatitis C patients aligns with general health guidelines, prioritizing whole foods and limiting fatty foods, salt, and sugar. One great diet choice that follows these guidelines is the Mediterranean Diet (14). 

​​Supplements and Vitamins for Hepatitis C Support

For patients interested in supplements and vitamins, various options can help to support liver function:

Vitamin D 

Adequate levels of vitamin D that support immune function is important for those with hepatitis C. Research suggests a link between vitamin D deficiency and the progression of liver diseases, including HCV. Supplementing may aid in slowing disease progression.

Omega-3 Fatty Acids

Omega-3 fatty acids can help manage liver inflammation and reduce liver damage. Additionally, they can combat associated insulin resistance, enhancing overall health in those with chronic HCV.

Nutraceuticals in Hepatitis C Treatment

While silymarin (milk thistle) is widely recognized as a nutraceutical to enhance liver function, studies have found that it does not significantly improve liver health or reduce hepatitis C virus levels in patients. Similarly, zinc supplements are considered to rectify zinc deficiencies commonly seen in hepatitis C patients, yet definitive evidence on their broader benefits remains inconclusive. 

Probiotics, often advocated for their general health benefits, have yet to show substantial advantages for hepatitis C patients. On another note, glycyrrhizin, an extract from licorice root, is under exploration for its potential in hepatitis C treatment, but individuals with certain health conditions should approach with caution.

Herbal Supplements for Hepatitis C

Colloidal silver, sometimes promoted as an herbal remedy for various conditions, lacks research-backed efficacy for hepatitis C. Notably, it poses the risk of side effects, including a distinct skin discoloration called argyria (16). 

Mind-Body Therapies for Hepatitis C

Mind-Body therapies for Hepatitis C include meditation, yoga, and stress reduction. 

Meditation for Hepatitis C Patients

Regular meditation practice can enhance relaxation, reduce stress, and foster a positive mindset, which can be instrumental in coping with symptoms and the side effects of treatments.

Yoga for HCV Treatment

Regular yoga practice can enhance physical flexibility, reduce fatigue, and improve overall health. Additionally, the deep breathing and relaxation techniques in yoga can aid in alleviating stress and anxiety associated with chronic illness (8). 

Stress Reduction in Hepatitis C Management

Chronic stress has the potential to exacerbate the symptoms of hepatitis C and hinder the body's healing processes. Implementing stress reduction techniques, such as deep breathing exercises, progressive muscle relaxation, and guided imagery, can play a vital role in hepatitis C management. 

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Summary

In summary, hepatitis C is a common condition that has the potential to cause severe health challenges. By combining traditional treatments with strategies like proper nutrition, beneficial supplements, and mind-body practices like meditation or yoga, patients have a comprehensive toolkit to address their health. Understanding this condition and using a variety of approaches helps both patients and healthcare professionals to ensure better health outcomes and improved quality of life.